MEDICARE: AHAVA NOSTRAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1548946817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHAVA NOSTRAND

Provider Business Mailing Address
First Line	:	19 FAYETTE ST FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-4597
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 FAYETTE ST FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-4597
Country	:	US
Telephone Number	:	718-438-3002
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MORDECHAI LEBOVITS
Credential	:
Telephone Number	:	718-438-3002

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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Directions to “AHAVA NOSTRAND ” Practice Location

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